Day: 28 January 2022

EIGHT More Nightingale Hospital Hubs Stand Empty as Surge Predicted by Government Models Fails to Appear

Eight Nightingale hospital surge hubs were built by the Government this winter for an undisclosed amount of money that now stand empty in anticipation of a wave that never came. MailOnline has more.

This is the first look inside one of the NHS‘ new Nightingale surge hubs – which officials concede might never be used as the Omicron wave continues to recede.

The temporary site on the grounds of Royal Preston Hospital is one of eight commissioned across England last month, when the fourth wave looked as if it could threaten the health service. 

It has been assembled in the car park at the city’s biggest hospital in less than four weeks and can house roughly 100 Covid patients – but it is currently empty. 

Local NHS bosses have indicated that the new hub might never be used and medical unions have warned it could swallow up staff and pull resources away from other parts of the health service. 

Other make-shift structures are being built in London, Leeds, Solihull, Leicester, Stevenage, Ashford and Bristol for an undisclosed amount of money.

England’s original Nightingale hospitals, built in 2020, cost a total of £500million, which included running costs, stand-by costs and decommissioning costs. But they saw only light use before being mothballed.

The new, smaller sites will remain on standby to look after Covid sufferers who are not well enough to go home but need minimal supervision during their recovery.      

Kevin McGee, chief executive of Lancashire Teaching Hospitals Trust which looks after the Royal Preston, previously said: “My hope is that we never have to use it. We’re planning for it, and that’s quite right because we need to make sure that we put the appropriate capacity in place should we need it, but I’m hopeful we can manage within our core bed base.”

However, Dr Brian McGregor, of the British Medical Association (BMA), said staffing more beds would mean “falling further behind” on routine work.

Worth reading in full.

Israel Covid ICU Admissions Hit Record Level Despite High Vaccination Rates and Early Booster Campaign

Covid ICU admissions in Israel hit record levels this week, reaching 130.5 per million on January 26th 2022, topping a previous peak of 127.1 per million on January 19th 2021. Why is this, when Omicron is milder and most of the country is now vaccinated whereas last winter almost none of it was?

At the previous peak only 6% of the country were double-vaccinated. Now 65% are, plus 46% are triple-vaccinated and around 8% are quadruple vaccinated. Israel was also first out the block with its booster campaigns. If the purpose of the vaccination programme was to relieve pressure on the health service – and recall it was supposed to be a two-dose vaccine, not three or four doses – it’s hard to see how it has helped much.

Having said that, the number of patients in ICU is still only around two thirds of the peak level, suggesting the stays may be shorter.

Also, deaths are currently less than half the peak – though as Dr. Noah Carl points out, this is higher than you would expect from 95% effective vaccines.

Latest Mortality Figures Suggest That Vaccine Effectiveness Has Been Overestimated

The ONS announced last week that there were 49,428 deaths registered in England in December, which is 1,200 more than in November, and 17.5% more than the five-year average.

Age-standardised mortality rates for leading causes of death other than Covid were close to their five-year averages, suggesting that Covid was the main reason for elevated mortality last month (see below). Although, as noted before, cause-of-death comparisons should be interpreted with caution.

December’s overall age-standardised mortality rate was 9.3% higher than the five-year average. This is a greater disparity than last month and the month before. Though it’s still less than that seen in September. Here’s my updated chart of excess mortality in England since January of 2020:

What’s more, December’s age-standardised mortality rate was 8% lower than the same month a year before. Notice that the bump for the winter of 2021 is slightly lower than that for the winter of 2020.  

While it’s certainly good news that mortality is lower, you might have expected a bigger reduction, given the many fewer people had natural immunity last December, and less than 1% of the population had been fully vaccinated.

Indeed, it’s noteworthy that going from under 1% fully vaccinated to more than 68% double vaccinated (including almost all elderly people) is only associated with 8% lower all-cause mortality.  

This is consistent with evidence from other European countries, where post-vaccination waves have been as or more deadly than pre-vaccination waves. Such data are hard to reconcile with claims of 90% vaccine effectiveness against death.

Majority of ‘Covid’ Hospital Patients in England are In For a Different Reason – Rising to Almost Two Thirds in London

The majority of Covid patients in hospitals in England are not primarily being treated for the virus for the first time, rising to almost two thirds in London, official statistics show. MailOnline has more.

As few as a third of inpatients are mainly sick with the virus in parts of the country, with the rest mainly receiving care for a range of other conditions, such as a broken leg or heart disease.

Experts have called for the breakdown of so-called ‘incidental’ cases to be published alongside daily Covid figures to reveal the true extent of NHS pressure.

There were 13,023 Covid patients in hospital on January 25th, according to the latest NHS England figures, of which only 6,256 were primarily there for the virus (48%). This share has plummeted since the emergence of the super-mild Omicron variant in late November, when three-quarters of inpatients were mainly ill with the disease. 

Professor Paul Hunter, an infectious diseases expert at the University of East Anglia, told MailOnline the figures highlighted that the worst of the pandemic was “certainly” over.

He said it was “absolutely” the time to start differentiating between primary and incidental Covid patients in the daily numbers.

“I think that data should be on the dashboard, giving more information is always better than giving less. It all fits in with the observation that Omicron is more infectious but less severe.” …

Just three of England’s seven NHS regions have more primary Covid patients than incidentals – the  North West (57%), South East (55%) and the North East and Yorkshire (54%).  

Little over a third of inpatients are primary Covid in London (36%) and the East of England (38%), while in the Midlands and the South West the proportion is 46% and 49%, respectively. 

Worth reading in full.

Should All Predictive Modelling Be Banned?

Today we’re publishing a piece by James Lewisohn, who says the problem with complex predictive models is they’re too unreliable to be trusted, but he’s not convinced they’re reliably unreliable enough to be banned.

What are the world’s worst inventions? Winston Churchill famously regretted the human race ever learned to fly. I don’t (I’m looking forward to my next holiday too much). Instead, observing the destruction wrought by government pandemic responses predicated upon projected Covid cases, I’m beginning to regret mankind ever invented the computer model.

I have form here. I spent the early years of my career building financial models, hunched over antique versions of Excel on PCs so slow the software might take twenty minutes to iterate to its results – which, once received, were often patently wrong. I developed a healthy mistrust for models, which frequently suffer from flaws of design, variable selection, and data entry (“Variables won’t. Constants aren’t,” as the saying goes).

Models allow outcomes to be presented as ranges. In business, it’s often the best-case outcome which kills you – early-stage companies typically model ‘hockey stick’ revenue growth projections which mostly aren’t realised, to the detriment of their investors. In pandemics, though, beware the worst case. In December, SAGE predicted that Covid deaths could peak at up to 6,000 a day if the Government refused to enact measures beyond Plan B.  The actual number of Covid deaths last Saturday: 262. 

SAGE’s prediction was its worst-case analysis, but the fact that the media (and then the Government) tends to seize upon the worst-case is nothing new. In 2009, Professor Neil Ferguson of Imperial College, to his subsequent regret, published a worst-case scenario of 65,000 human deaths from that year’s swine flu outbreak (actual deaths: 457). As Michael Simmons noted in the Spectator recently: “The error margin of pandemic modelling is monstrous because there are so many variables, any one of which could skew the picture. Indefensibly, Sage members are under no obligation to publish the code for their models, making scrutiny harder and error-correction less likely.”

Worth reading in full.

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